RSS Feedhttps://10.40.239.129/blogs/rss-feed/Blog RSS Feeden{8F031740-4876-4354-A4E9-2AB528505FA2}https://10.40.239.129/blogs/2015/07/heart-healthy-recipe-ginger-lime-chicken-skewers/Heart-healthy Recipe: Ginger Lime Chicken Skewers<p>I've shared this recipe with the 15 Utah moms I am working with as part of the Intermountain Medical Center Heart Institute's <a href="http://www.myheartchallenge.org" target="_blank">My Heart Challenge: Moms Edition</a> and invite you to try this recipe as well.&nbsp;</p>
<p><strong>INGREDIENTS</strong></p>
<ul>
<li>2 boneless skinless chicken breasts (cut lengthwise into three strips)</li>
<li>NOTE: You can also use chicken tenders</li>
<li>For the marinade:</li>
<li>1 T canola oil</li>
<li>1/2 t crushed red pepper flakes</li>
<li>2 T soy sauce</li>
<li>1 t fresh ginger (minced)</li>
<li>1 clove garlic (minced)</li>
<li>lime juice (1 lime)</li>
</ul>
<p><strong>DIRECTIONS</strong></p>
<ol>
<li>Place a wooden (or metal) skewer through each chicken strip. Place on a plate or in a plastic container.</li>
<li>Whisk all marinade ingredients together and pour over chicken skewers.</li>
<li>Cover and refrigerate chicken for 1-2 hours.</li>
<li>Preheat oven to 375 degrees.</li>
<li>Roast chicken skewers until cooked through (roughly 15 minutes). Grilling is also a great option.</li>
</ol>Fri, 10 Jul 2015 00:00:00 -0600{D897D113-F661-4EC5-85E3-43400DA22332}https://10.40.239.129/blogs/2015/07/recognizing-depression-in-yourself-and-your-loved-ones/Recognizing Depression in Yourself and Your Loved OnesDepression can be a subtle feeling that influences all aspects of our lives, or it can be a dramatic feeling that prevents us from enjoying any aspect of our lives at all.&nbsp;
<p>I am amazed at how many people don&rsquo;t realize they are depressed when they come in complaining of &ldquo;just feeling off.&rdquo; I will ask, Do you have any stressors in your life right now? &ldquo;Just the usual,&rdquo; is a common but valuable response. What&rsquo;s the usual? I ask. Then, my patient often replies with something distressing like, &ldquo;Well, things are really tight financially and that&rsquo;s causing a lot of friction between my spouse and I.&rdquo;&nbsp;
</p>
<p>Recently a man told me how he had bills to pay, but he didn&rsquo;t know if would have a job tomorrow, because his company had been downsizing a lot of staff. Another woman told me, &ldquo;I hate my job but can&rsquo;t afford to leave it.&rdquo; The numbers about depression are also astounding &ndash;nine percent of the population will struggle with severe depression at some point in their lives.&nbsp;
</p>
<p><strong>TRIGGERS &amp; SYMPTOMS</strong>&nbsp;</p>
<p>People facing stressors, confronting chronic illness, living in an unstable environment, or who have a family history of depression are at the highest risk for developing severe depression. As physicians, when we discuss depression in the office with patients, we usually describe it as being on a spectrum, with the genetic element on one end, and the situational element on the other end.&nbsp;
</p>
<p>We are all somewhere in the middle. Some people inherit a larger genetic component, and so it only takes a small trigger for depression to seep into their lives. Other people who have a smaller genetic component need one or more larger triggers to become depressed. Whatever genes we have, we play the hand we&rsquo;ve been dealt. For some people depression will be something they deal with throughout their lives. Fortunately, there are many great strategies to cope with and treat it.&nbsp;
</p>
<p>Some patient populations experience depression symptoms that are different from the norm. For example, with patients aged 60 or older, we often see anger or irritability as the main presenting symptom. These are people who have been kind and happy all their lives, but as their bodies stop behaving the way their minds feel, sometimes bitterness will start to emerge that was never there before.&nbsp;</p>
<p><em><strong>&ldquo;Among adolescents, distinguishing between normal teenage angst and depression can be challenging.&rdquo;&nbsp;
</strong></em></p>
<p>Depression is not a normal part of aging. Chronic health issues and functional decline, which can be the cause of the depression, may also make it difficult to recognize the depression for what it is. Patients 60 years of age and older do not usually feel &ldquo;depressed&rdquo; in terms of feeling sad or blue. So, when the possibility of depression is brought up, it is quickly dismissed, even though the other symptoms are present, and the patient would likely have a much better quality of life with treatment.&nbsp;
</p>
<p><strong>AMONG ADOLESCENTS</strong>&nbsp;</p>
<p>Among adolescents, distinguishing between normal teenage angst and depression can be challenging. Many parents get concerned, but calm themselves down with justifications such as, &ldquo;It&rsquo;s just a phase, and he&rsquo;ll grow out of it.&rdquo; The safest course with teenagers is avoiding unnecessary risks. If a new pattern of behavior is persisting for more than two weeks or if your teenager seems withdrawn and less interactive, talk to him or her about it. If you discover a clear explanation, great. It gives you a concrete issue to deal with, and it offers you peace of mind that the issue is not something more severe. If a teen says he or she is feeling depressed or cannot put feelings into words, then come in to your physician so we can screen for depression.&nbsp;
</p>
<p><strong>TESTS &amp; DIAGNOSES</strong>&nbsp;</p>
<p>The first thing a doctor will do in the office is ask a few questions about your mood. Our current diagnostic tools are based on the criteria for major depressive disorder. The next step, when making the diagnosis, is screening for other conditions that may appear like depression. Thyroid disorders often appear similar to depression, and a quick test at the doctor&rsquo;s office can rule that out, if that&rsquo;s the case. Anemia and electrolyte disorders can also cause you to feel sluggish and not yourself. We look for any problems related to alcohol or substance use, including prescription medications that can cause you to feel depressed.&nbsp;
</p>
<p><strong>MEDICATION</strong>&nbsp;</p>
<p>Many people can&rsquo;t stand the idea of taking a medication for something they feel they should be able to &ldquo;just snap out of.&rdquo; If only it really were that easy! We don&rsquo;t recommend taking pills for every up and down in your mood, but if it is affecting your functioning and it is lasting for more than two weeks, there are great treatments available. When the option is taking a pill so people can enjoy life and handle stressors and responsibilities, most people choose to take the pill. They want to stop suffering through their depression, dropping the ball, and watching things get worse.&nbsp;
</p>
<p><strong>Medication</strong> is only part of the treatment. For some people it is all that is needed, and after a few weeks they are functioning well and feeling like things are getting back to normal. Many people with severe depression, that is either recurring or that lasts longer than expected, will also do well with a counselor.&nbsp;
</p>
<p>It is a good thing to have a professional, emotionally uninvolved person with whom to discuss what is going on and may be triggering the depression. It can be very difficult for people to have these discussions with their spouse or loved ones because the loved ones may feel defensive or thoughtlessly dismiss a depressed person&rsquo;s experiences.&nbsp;
</p>
<p>It is important to know that most medications take several weeks before the results are noticeable to the person taking them. There have been many times when I&rsquo;ve had a husband and wife in the office talking about the depression, and the person on the medication says, &ldquo;I really don&rsquo;t feel any different. I don&rsquo;t know if it&rsquo;s working or not.&rdquo; Immediately, the other spouse interjects, &ldquo;This is a night and day difference! If they stop the pill, I&rsquo;m leaving!&rdquo;&nbsp;
</p>
<p>The reason is, when an antidepressant works, you feel normal, and your body doesn&rsquo;t really notice when you feel normal.
Eventually you&rsquo;ll realize that, &ldquo;I&rsquo;m waking up at a normal time, I&rsquo;m sleeping okay, and I&rsquo;m starting to enjoy life again.&rdquo; But usually your family and close friends will notice those things way before you ever do. So, if you want to know if the medication is working, let a trusted person know you are starting to take the medication, and ask for feedback. If they can point out things with comments such as, &ldquo;Yesterday when the kids started to get rambunctious, you took it in stride instead of flying off the handle,&rdquo; you&rsquo;ll start to realize that your depression symptoms are lifting.&nbsp;
</p>
<p>Sometimes finding the right pill is a matter of trial and error, and this can be frustrating because each new pill will take several weeks before you can expect to see it work. Just keep in mind that there are plenty of good medication options. If you are patient, you and your doctor will find one that works well for you.&nbsp;
</p>
<p><strong>TALK TO YOUR DOCTOR</strong>&nbsp;</p>
<p>If you think you may have depression, let your doctor know. If your depression symptoms seem to last for more than two weeks, you can&rsquo;t easily pinpoint a specific reason for them, or if your symptoms are affecting your functioning, see your doctor. We can help you get back to enjoying your life again.
</p>Thu, 09 Jul 2015 00:00:00 -0600{DEB86304-FA73-4458-8D62-C3BA895D3AAE}https://10.40.239.129/blogs/2015/07/the-apc-will-see-you-now/The APC will see you nowIf you have visited an Intermountain Healthcare facility lately, you&rsquo;ve probably met an advance practice clinician or APC. These professionals are non-physician healthcare providers who have advanced training at the graduate level and have passed a national board examination to practice as a non-physician healthcare provider in their state. APCs are being utilized in most healthcare facilities such as hospitals, clinics, emergency rooms, InstaCare clinics, homecare services, hospice programs, and specialty clinics.&nbsp;
<p>APC professions emerged in the 1950s. Initially, doctors started training nurses and expanding the scope of their practice to perform increasingly sophisticated services. In 1965, federal legislation launched the Medicare and Medicaid programs, which helped more aged, poor, and disabled Americans to afford and access physician services. Almost overnight, this new demand for health care created a doctor shortage. In addition, Medicare and Medicaid policies were also calling for an increase in specialist physicians, which directed medical school graduates to residencies in specialties instead of in primary care disciplines. This further fueled the primary care doctor shortage. At that time there were simply not enough medical school programs to produce the number of physicians necessary to meet the rising healthcare demands. This need lead to establishment of the first official advanced practice registered nurses (APRN) and physician assistants (PA) training programs in 1965. The first APRN training program was established by Henry Silver and Loretta Ford. Duke University launched the first PA professional program. Since then, there have been more than 350 APRN and 150 PA programs established across the country.&nbsp;
</p>
<p>Education and training for APRNs and PAs both include anatomy, physiology, pharmacology, pathophysiology, as well as genetic and other mechanisms of disease. The clinical portion of PA training is comprised of both inpatient and outpatient settings in a variety of areas including emergency medicine, family medicine, general surgery, pediatrics, orthopedic surgery, obstetrics and gynecology, the internal medicine specialties, and many other disciplines. For APRNs the clinical portion covers a wide spectrum of primary care similar to the PA. In addition, the APRN specializes in one area of clinical expertise.&nbsp;
</p>
<p><strong>The Healthcare Provider Shortage</strong>&nbsp;</p>
<p>Our nation continues to be at the forefront of a shortage of healthcare providers due to an aging population, the implementation of the Affordable Care Act, and the continued shortage of physicians. APCs are filling the gaps in the physician shortage around the nation. This is evidenced by the fact that the number of visits performed by APCs in the outpatient setting increased by five percent between 2001 and 2009.&nbsp;
</p>
<p>In the state of Utah there are approximately 1,445 APRNs and 1,900 PAs in practice. More than 106,000 APRNs practice in the United States, as well as 93,000 PAs. APCs are also filing the gaps by providing care to populations that are currently under-served such as rural communities and uninsured populations.&nbsp;
</p>
<p>APCs are crucial today to give patients access to quality health care at a reasonable cost. Current studies show that APCs are spending more time with the patients than physicians, and they are doing this with excellent patient satisfaction scores. So, the next time you visit an Intermountain Healthcare facility, consider scheduling your appointment with an APC.&nbsp;
</p>
<p>Advance Practice Registered Nurse&rsquo;s
education follows the nursing process, which includes a systematic method that directs the nurse and patient as they work together to provide holistic, patient-centered care. APRNs are registered nurses who have practiced in the field of nursing prior to entering a graduate training program. To be eligible to apply for an APRN program, the nurse must complete a bachelor&rsquo;s degree and have specialty nursing experience in the field of the degree they are seeking. Most APRN programs are a minimum of three years resulting in a master&rsquo;s degree, doctoral degree or a PhD. APRNs must also pass a national board exam for certification and licensure. Once licensed, APRNs must complete additional continuing education courses in their field of study to maintain an active license.&nbsp;
</p>
<p>A Physician Assistant generally has a bachelor&rsquo;s degree before starting their training as well as a number of years of medical experience in various fields. There are some PA programs that offer an integrated undergraduate degree within the PA program. All PA programs award their graduates with master&rsquo;s degrees. The PA education follows the example of formal medical school training. The total time of the PA training is about 27 months of continuous study with over 2,000 hours spent in clinical training mentioned above. Once licensed, a physician assistant must complete 100 hours of continuing medical education every two years. They must also pass the board examination after graduation from their training and repeat the test every ten years.&nbsp;
</p>
<p>APCs work in a variety of clinic and hospital settings. Physicians who employ and use APCs in their clinics can devote more time to complicated, high-risk patients. They can also accept more patient referrals and increase the availability of appointments. APCs help by conducting physical exams, ordering and interpreting tests, diagnosing and treating illnesses, counseling patients on preventative health care, assisting with surgery, and writing and refilling prescriptions. In the hospital, APCs perform many of the same duties as they do in the outpatient clinic. They work with physicians to provide updated assessments and evaluations of the patient&rsquo;s condition. They also review and evaluate the recent laboratory and other diagnostic tests performed.&nbsp;
</p>
<p>APCs update the physician on the patient status and any problems that were discovered. They can also write appropriate orders regarding the patient&rsquo;s care and perform skilled procedures during the hospitalization either independently or with the assistance of the physician. APCs provide education to patients and their families regarding their diagnosis, plan of care, treatment options, medications and diagnostic testing. In surgery, the APC works alongside the physician during the surgical procedure. They also provide the patient and family with pre- and post-op education, and they write post-hospital prescriptions. All APCs have a collaborative physician who is responsible to be available for consult and patient referral as needed. APCs are able to provide care independently without the need to consult a physician at every patient encounter. Each APC has a practice agreement contract with their employer. This document identifies when consultation between a physician and an APC should occur such as with high-risk patients or when complicated problems arise.
</p>Thu, 09 Jul 2015 00:00:00 -0600{3E81C40B-94FD-4DC8-978B-D4B4845EC8F4}https://10.40.239.129/blogs/2015/07/5-exercises-to-stay-active-at-your-desk-job/5 Exercises to Stay Active at Your Desk Job<p class="p1">I recommend that people who sit a lot in their jobs, do gentle exercises throughout the day. It's a great way to help the fluids in the body move a little better, as well make your inactive job a little more active.&nbsp;&nbsp;</p>
<p class="p1">Do the following exercises twice a day to help you maintain flexibility and strength.</p>
<ol>
<li>Marching:&nbsp; While sitting, lift one knee, then put it down.&nbsp; Then, lift the other knee and put it down.&nbsp; Do this 10 &ndash; 15 times.</li>
<li>Kicks: While sitting, straighten one leg at the knee and return it to the starting position.&nbsp; Then, straighten the other leg at the knee and return in to the starting position.&nbsp; Do this 10 &ndash; 15 times.</li>
<li>Ankle Alphabet: Move your feet to spell the letters of the alphabet.&nbsp; Go through the alphabet at least 2 times with each foot.</li>
<li>Calf Stretch: Sit with your legs straight out in front of you.&nbsp; Loop a towel around the ball of one foot.&nbsp; Gently pull the towel, keeping your knee straight.&nbsp; Hold this position for 30 seconds.&nbsp; Repeat 5 times.&nbsp; Then, switch legs and repeat.</li>
<li>Hamstring Stretch: Sit with your legs straight out in front of you.&nbsp; Reach to touch your toes, keeping your knees and back straight.&nbsp; Hold this position for 30 seconds.&nbsp; Repeat 5 times.</li>
</ol>Thu, 09 Jul 2015 00:00:00 -0600{E40C46CB-AC5C-4559-8085-F571AE8B8AB4}https://10.40.239.129/blogs/2015/07/the-importance-of-treating-sleep-problems/The Importance of Treating Sleep ProblemsUntreated sleep problems are clearly linked to a greater chance of having obesity/overweight, heart disease, high blood pressure, stroke, diabetes, abnormal heart rhythms, congestive heart failure, atrial fibrillation, depression, anxiety, and getting into car accidents. And, don&rsquo;t forget excessive daytime sleepiness, low energy, bad sleep, and constant poor quality of life!&nbsp;
<p>None of us need more risk for these problems than we already have. Patients who already have these health problems often find that successful treatment for the sleep problem can improve their condition or allow them to use less medication. With successful treatment, you will likely sleep better, feel better, have more energy, live longer, and be more healthy! Please consider seeking treatment if you or someone you care about has signs or symptoms of sleep apnea.&nbsp;
</p>
<p><strong>Sleep Apnea Treatment Options</strong>&nbsp;</p>
<p>We take a comprehensive approach at McKay Dee Sleep Center. Many patients ask me to review their options for the treatment of their sleep apnea. The following treatment options are for obstructive sleep apnea, which is the most common variety of sleep apnea. Another variety, central sleep apnea, may be treated with some of these options but may also require different treatment. Consult with your doctor about your specific needs.&nbsp;
</p>
<p>Basically, obstructive sleep apnea happens because the upper throat is closing off when a person is trying to breath during sleep. Therefore the treatment is often directed at keeping the throat open. There are various ways of doing this.&nbsp;
</p>
<p><strong>1) PAP</strong>
(also known as CPAP, Continuous Positive Airway Pressure, BiPAP, ASV, APAP, VPAP, BiLevel PAP, etc.) is a small, quiet air compressor, which sits at your bedside and blows some air into a mask on your nose. In most patients a minimal stream of air pressure keeps their throat from closing off and it eliminates snoring and sleep apnea. It is the most popular treatment for snoring and sleep apnea because it works very well for most people and has very low risk. The drawback is&mdash;just like wearing eyeglasses&mdash;PAP only works if you are wearing it. Thankfully, sleep apnea only happens when you are sleeping so you only wear PAP while sleeping.&nbsp;
</p>
<p>Most people get used to PAP quickly and are able to use it for most of each night. Some people struggle to get used to it and then stop using it. We have found the large majority of these people did not have a professional helping them. There are many things we can do to make PAP treatment successful. There are many types of masks. It&rsquo;s like finding a comfortable pair of shoes; they might feel fine in the store, but the real test is to wear them for a while.&nbsp;
</p>
<p>Most health plans will cover PAP, but some may not pay for the more expensive types of machines. If our doctors prescribed a type of PAP your insurance does not pay for, we recommend that you speak with your insurance company and try to convince them to change their minds. Our doctors only recommend what they believe is best for your medical treatment.&nbsp;
</p>
<p>If you select PAP as your treatment, your physician will send a PAP prescription to a local durable medical device (DME) company. This DME company functions like a pharmacy for medical equipment, and they will give you the PAP device and mask, etc. They will help you get comfortable with PAP and provide maintenance as needed. Once you are all set, chances are you only have to return to the sleep clinic for a doctor visit once a year, and maybe get a another sleep study in five to ten years. If you gain weight, you may need those visits sooner &ndash; which is just more motivation to keep the weight off!&nbsp;
</p>
<p><strong>2) Weight loss &ndash;</strong> People who have sleep apnea are much more likely to be overweight. The weight problem may actually be causing part of the sleep apnea! Weight loss is regularly recommended as a way to help reduce sleep apnea. Once an overweight person reaches their ideal body weight, their sleep apnea might be gone! It is also a good idea to be at your ideal body weight for many other health reasons. However, losing weight on your own can be very difficult. Weight management programs recommended by your doctor are a great place to get started. Weight management programs can greatly increase your odds of reaching and staying at your most healthy weight. Some weight management programs include surgery (bariatric weight loss surgery) as an option, which can be quite effective at helping to reduce weight and sleep apnea&mdash;but may not be covered by insurance.&nbsp;
</p>
<p><strong>3) Dental Appliances</strong>
(aka: dental device, oral appliance, mandibular advancement device, etc.) are like retainers that are fitted to your teeth and hold your jaw slightly forward and slightly open while you sleep. By doing so, dental appliances pull the tongue forward, help keep the throat open, and prevent snoring and sleep apnea. They are usually made by a dentist. The do-it-yourself ones are not recommended because they have less of a chance of working and more of a chance of side effects (problems with teeth, gums, bite, jaw discomfort, etc.). Also, not all dentists are equally qualified to make these. Try to see someone who has a lot of experience in this area. It is easy to make these devices, but it is hard to make really good ones&mdash;that takes an expert.&nbsp;
</p>
<p>If you can you answer positively to three or more of these questions you are in the high-risk category for sleep apnea:&nbsp;</p>
<p>&bull; Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?&nbsp;
</p>
<p>&bull; Do you often feel tired, fatigued, or sleepy during daytime?&nbsp;
</p>
<p>&bull; Has anyone observed you stop breathing during your sleep?&nbsp;
</p>
<p>&bull; Do you have or are you being treated for high blood pressure?&nbsp;</p>
<p>&bull; Is your BMI more than 35 kg/m2?&nbsp;</p>
<p>&bull; Are you 50 years of age or older?
&bull; Is your neck circumference greater than 17 inches?&nbsp;</p>
<p>&bull; Are you a male?&nbsp;
</p>
<p>The dental device is worn during sleep and is removed when you are awake. It is usually only recommended for folks who have at least eight teeth on the top and eight on the bottom. After the device is fitted to you, a follow-up sleep study is recommended to find out if it sufficiently reduces your sleep apnea. It works in about half of the cases that are considered mild or moderate sleep apnea. Some people will use a dental appliance when they travel and a PAP machine when they are sleeping at home. This treatment may or may not be covered by your insurance. (It is usually part of your medical coverage, not dental coverage.)&nbsp;
</p>
<p><strong>4) Surgery &ndash;</strong> There are various surgeries that can help open up the throat and reduce snoring and sleep apnea. Surgery is the first choice for sleep apnea treatment in most children, because the results are often very good and kids often have a tough time tolerating PAP. In adults, surgery may or may not work well. The best way to find out if surgery can help you is to see a surgeon for a consultation. We recommend seeing someone who is very experienced in this specific area, because the results depend greatly on the type of surgery chosen for you and the surgeon who is doing the procedure. A sleep study is often done several months after surgery to see how well it worked for you.&nbsp;
</p>
<p><strong>5) Provent &ndash;</strong> This device is like a small oval Band-Aid, with a valve, that sticks to the end of your nose and prevents some of the air from escaping when you breathe out. This produces a type of back pressure in your throat, and this back pressure tends to keep the throat from closing off while you sleep. It may or may not work and tends to be recommended for mild or moderate sleep apnea only. Sleep doctors usually recommend a follow-up sleep study to make sure it works well enough for you. If your insurance does not cover this treatment, it costs about a dollar or two per night.&nbsp;</p>
<p>The Provent oval devices are discarded after each nights use.&nbsp;
</p>
<p><strong>6) Newly Approved Treatments &ndash;</strong> Inspire is like a pacemaker for your throat muscles. It senses when you breathe in while sleeping and will send a message to the throat muscles to keep them firm. This helps keep the throat open and reduces sleep apnea. It is FDA approved. Visit www.inspiresleep.com to learn more.&nbsp;</p>
<p>Winx is like the opposite of PAP. It has a mouth piece that produces suction rather than positive pressure and has shown some encouraging results. The manufacturer&rsquo;s website is http://apnicure.com/.&nbsp;
</p>
<p><strong>7) Body Position &ndash;</strong> Certain body positions can help reduce snoring and sleep apnea. Sleeping on your back can increase the chance of these problems, and sleeping on your side can reduce the chance of these problems. Of course you are unconscious when you are asleep, so it can be hard to reliably stay off your back all night. Also, during REM (dreaming) sleep, studies have shown that some people lose the beneficial aspects of sleeping on their sides. Before you rely on positional treatment, you should discuss it with your doctor because it is not as straightforward as it seems.&nbsp;
</p>
<p><strong>8) Nasal Passages &ndash;</strong> Although sleep apnea does not happen in the nose, it can be worse if the nasal passages are clogged. If you have regularly congested nasal passages, please consider discussing treatment for them with your doctor as this may help snoring and sleep apnea. Clearing your nasal passages may help you get greater benefit from some of the other treatments like PAP.&nbsp;
</p>
<p><strong>9) Pillows &ndash;</strong> At least one pillow has been approved for snoring and even mild sleep apnea, but many pillow marketers just make unsubstantiated claims. Although the position of the head and neck can make a difference to healthy sleep and breathing, beware of false claims.&nbsp;</p>
<p><strong>10) Other Remedies &ndash;</strong> Many other treatments have been suggested for sleep apnea like strengthening the throat muscles with exercises or using homeopathic sprays, etc. To date, none have been shown to reliably treat sleep apnea. Throat exercises are being looked at again and may be promising, so stay tuned! Review any sleep apnea treatment you select with your doctor before using it.&nbsp;
</p>
<p><strong>Finally:</strong> The bottom line is you really need to consider successfully treating your sleep apnea if you want to be healthy and enjoy your life and family, to the fullest. At the very least, take the first step and see your doctor or visit a sleep specialist in your area. We&rsquo;re anxious to help out!&nbsp;
</p>
<p><strong>Here are some good websites for more information to help your decision:</strong>&nbsp;</p>
<p>&bull; National sleep foundation:
http://sleepfoundation.org/&nbsp;
</p>
<p>&bull; Harvard Medical School sleep
http://healthysleep.med.harvard.edu/&nbsp;
</p>
<p>&bull; National Institutes of Health:
www.nhlbi.nih.gov/about/ncsdr&nbsp;
</p>
<p>&bull; American Academy of Sleep Medicine:
http://yoursleep.aasmnet.org/</p>Thu, 09 Jul 2015 00:00:00 -0600{660B2B53-833A-4BC8-8972-F1E95925DD98}https://10.40.239.129/blogs/2015/07/three-wrong-ways-to-run-and-their-solutions/Three wrong ways to run and their solutions&ldquo;One practice runners fall into is the tendency to &lsquo;heel strike&rsquo; or land too severely on the heels of their feet during a run,&rdquo; said Chad Allred, physical therapist at American Fork Hospital. &ldquo;If your stride is too far out when you heel strike, the heels then act like a brake, and the momentum is transferred up through the joints rather than the muscles, causing potential joint injuries in the legs.&rdquo;&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
Allred suggested runners&rsquo; feet should be more under their center of gravity when running so their leg muscles take the force rather than the joints. He advised shortening stride length to land with a slight heel-foot strike, mid-foot or even a subtle forefoot strike, keeping away from a full-force land on the heels.<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
Another common problem to look out for is trunk rotation, or how much the upper body is twisting from side to side. Excessive trunk rotation can negatively affect speed and efficiency during a run.&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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Allred said one strategy to address this is to pay attention to changes in speed, which may give runners queues to think about form and try to correct it. He recommended trying a phone app to help such as TempoRun, which allows you to keep track of your pace, or AudioStep, which measures your cadence (how often your feet touch the ground) while running.&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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A third common mistake for runners is under-training or failing to prepare their bodies for the extent of the race. &ldquo;One of the biggest mistakes in preparing for a long run is not training adequately for the distance of it,&rdquo; Allred said. &ldquo;If you&rsquo;re preparing for a half-marathon (13.1 miles), and train by running only six or seven miles, you set yourself up for injury because the race is significantly more mileage than your training distance.&rdquo;&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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The physical therapist said it&rsquo;s also critical to prepare for the terrain of a race. If the course includes downhill terrain, the participants need to have some of that in their training.Thu, 09 Jul 2015 00:00:00 -0600{12161090-04DF-4E18-86B8-AB472CAE4172}https://10.40.239.129/blogs/2015/07/a-pinch-of-salt-or-less/A Pinch of Salt or LessSalt &ndash; and more particularly the sodium component of salt &ndash; has come under increasing fire of late for its role in exacerbating certain health conditions. According to the Centers for Disease Control and Prevention (CDC), &ldquo;about 90% of Americans eat more sodium than is recommended for a healthy diet. Too much sodium increases a person&rsquo;s risk for high blood pressure. High blood pressure often leads to heart disease and stroke.&rdquo;&nbsp;
<p><strong>How much sodium do I need?</strong>&nbsp;</p>
<p>Americans typically consume more than 3,000 mg of sodium per day. The U.S. Dietary Guidelines recommend that Americans limit their sodium intake to 2,300 mg per day.&nbsp;
</p>
<p><strong>Adults who should be especially cautious with sodium intake, include:</strong>&nbsp;</p>
<p>&bull; Those 50 years of age or older&nbsp;</p>
<p>&bull; African-Americans&nbsp;</p>
<p>&bull; Those with a history of high blood pressure, diabetes, kidney disease, heart disease, or fluid retention&nbsp;
</p>
<p>To give you some perspective, <strong>one teaspoon of salt contains just over 2,300 mg of sodium!</strong> Even adding a pinch of salt, roughly 1/8 teaspoon, to a dish adds about 300 mg of sodium.&nbsp;
</p>
<p><strong>What foods are high in sodium?</strong>&nbsp;</p>
<p>According to the CDC, 44% of the salt we consume comes from ten specific foods:&nbsp;</p>
<p>&bull; Breads and rolls&nbsp;</p>
<p>&bull; Cold cuts and cured meats such as deli or packaged ham, or turkey&nbsp;</p>
<p>&bull; Pizza&nbsp;</p>
<p>&bull; Fresh and processed poultry&nbsp;</p>
<p>&bull; Soups&nbsp;</p>
<p>&bull; Sandwiches such as cheeseburgers&nbsp;</p>
<p>&bull; Cheese&nbsp;</p>
<p>&bull; Pasta dishes&nbsp;</p>
<p>&bull; Meat-mixed dishes such as meatloaf with tomato sauce&nbsp;</p>
<p>&bull; Snacks such as chips, pretzels, and popcorn</p>
<p>Too much sodium increases a person&rsquo;s risk for high blood pressure. High blood pressure often leads to heart disease and stroke. &nbsp;</p>
<p>Manufacturer-prepared foods and restaurant-prepared dishes are significantly higher in salt than home prepared foods, generally speaking. Some foods can be surprising in their salt content. For instance, a &ldquo;healthy&rdquo; sandwich made of two slices of whole wheat bread, deli turkey, cheese, lettuce, tomato, onion, mustard, and light mayo provides a total of 2,100 mg of sodium &ndash; an entire day&rsquo;s worth even without the salty potato chips on the side!&nbsp;
</p>
<p>You can find more tips for low-sodium eating at www.intermountainhealthcare.org. My favorite online resources for low-sodium recipes include:
www.heart.org; www.sodiumgirl.com; and www.lowsodiumcooking.com.&nbsp;
</p>
<p>Also, keep in mind that your taste preferences for salt will change with time. While you may miss the saltiness of a dish initially, continuing to cook and eat low-sodium foods will allow you to start to recognize the other wonderful flavor nuances in foods. Eventually, you won&rsquo;t even miss that pinch of salt!
Americans typically consume more than 3,000 mg of sodium per day. &nbsp;</p>
<p><strong>How do I decrease my salt intake?</strong>&nbsp;</p>
<p>Decreasing your salt intake doesn&rsquo;t have to be hard. Here are some easy tips to get started:&nbsp;</p>
<p>&bull; When grocery shopping, purchase &ldquo;No Salt Added&rdquo; or &ldquo;Low Sodium&rdquo; varieties of foods.&nbsp;</p>
<p>&bull; Cook at home more often. Making your own pasta sauce, for instance, can really be quite simple and it tastes great!&nbsp;</p>
<p>&bull; Add flavor without adding salt &ndash; experiment with salt-free herbs, spices, vinegars, and extracts.&nbsp;</p>
<p>&bull; Read food labels to become more familiar with the sodium content in the foods you regularly eat. Limit foods with more than 200 mg per serving.&nbsp;</p>
<p>&bull; Watch the ingredient list for any ingredient containing the words sodium, baking soda, or baking powder.&nbsp;</p>
<p>&bull; Eat more fresh fruits and vegetables.&nbsp;</p>
<p>&bull; Skip the salt in recipes whenever possible.&nbsp;</p>
<p>&bull; Don&rsquo;t add extra salt at the dinner table. Choose to add pepper instead.&nbsp;</p>
<p>&bull; Ask restaurants to not add salt when preparing your order.</p>Thu, 09 Jul 2015 00:00:00 -0600{1AEA97CB-D037-442B-83EF-866992FF6E49}https://10.40.239.129/blogs/2015/07/abdominal-aortic-aneurysm/Abdominal Aortic AneurysmNew Treatment Speeds Recovery&nbsp;
<p>An Abdominal Aortic Aneurysm, or AAA, is an abnormal enlargement or bulge in the abdominal section of the aorta, the body&rsquo;s largest artery that carries blood from the heart to all parts of the body. An aneurysm can cause the aorta to grow to several times its natural size, weakening it, and possibly causing it to rupture.&nbsp;
</p>
<p>Until the last decade, invasive surgery was the primary recourse to prevent abdominal aortic aneurysms from becoming deadly. A less-invasive technique called endovascular stent graft repair, however, is changing the treatment protocol and resulting in less blood loss, fewer days of hospitalization and a potentially faster recovery time for patients with AAA.&nbsp;
</p>
<p><strong>Open Surgery</strong>&nbsp;</p>
<p>In conventional or open surgery, the surgeon reaches the aneurysm through a large incision in the abdomen. The weakened section of the vessel, where the aneurysm has formed, is usually surgically removed and replaced with a synthetic material. Open surgery is usually performed under general anesthesia and takes about four to five hours to complete. Repairing the aneurysm surgically is complex and requires an experienced vascular surgical team. After surgery, the patient usually stays in the Intensive Care Unit a day or two, and then another five to seven days in the hospital. The full recovery time may be about three to six months.</p>
<p><strong>Endovascular Stent Graft Repair</strong></p>
<p>Endovascular Abdominal Stent-Grafting was invented in the early 1990s as a less-invasive endovascular method of repair of an abdominal aortic aneurysm and has rapidly expanded as the treatment of choice due to its clinical benefits.&nbsp;</p>
<p>The procedure involves two skin punctures or small incisions in the groin area, where the stent-graft is inserted into the femoral artery through a catheter to reline the abdominal aorta. The stent graft is a woven fabric tube supported by a tubular metal scaffold. The device is placed inside the diseased abdominal aorta without a major surgical incision and seals off the aneurysm by fitting inside the diseased part of the aorta, making a new path for blood to flow.&nbsp;
</p>
<p>The procedure can be done under general, regional or local anesthesia and typically takes one to two hours to complete. The hospital stay is generally one to two days, and patients can expect to resume normal activities in one to two weeks after the procedure. Regular follow-up is needed to evaluate and ensure the success of the stent graft treatment over time. The endovascular treatment of AAA has become the treatment of choice at McKay-Dee Hospital, where surgeons have been performing this procedure successfully for the past 10 years.&nbsp;</p>
<p><strong>Risks and Symptoms for Aortic Aneurysm</strong>&nbsp;
</p>
<p>Abdominal aortic aneurysms are most often caused by a weakening in the aortic wall, resulting from vascular disease, traumatic injury or a genetic defect. In addition, as we age, high blood pressure can cause the aorta to bulge out, thin and weaken, resulting in an aneurysm. Men older than 60, smokers, and those with a family history are most at risk.&nbsp;
</p>
<p>The risk of an abdominal aortic aneurysm increases for patients who:&nbsp;</p>
<p>&bull; Smoke.&nbsp;</p>
<p>&bull; Have high blood pressure.&nbsp;</p>
<p>&bull; Have high cholesterol.
&bull; Are overweight.&nbsp;</p>
<p>&bull; Have a family history of aneurysms, cardiovascular or peripheral vascular disease (narrowing of the blood vessels).&nbsp;
</p>
<p>Abdominal aortic aneurysms may go unnoticed initially because patients may not feel any symptoms. Frequently, an AAA is discovered incidentally on an imaging study such as an abdominal ultrasound or CT scan of the abdomen.&nbsp;
</p>
<p><strong>When symptoms are experienced, the most common are:</strong>&nbsp;</p>
<p>&bull; Pain in the abdomen, chest or lower back, possibly spreading to the groin, buttocks or legs. The pain may be deep, aching, gnawing and/or throbbing, and may last for hours or days. It is generally not affected by movement.&nbsp;</p>
<p>&bull; A pulsating sensation in the abdomen.&nbsp;</p>
<p>&bull; Back pain, if the aneurysm is pressing on the spine.&nbsp;</p>
<p>&bull; A &ldquo;cold foot&rdquo; or a black or blue painful toe if an AAA produces a blood clot that breaks off and blocks blood flow to the legs or feet.&nbsp;</p>
<p>&bull; Fever or weight loss, if the AAA is an inflamed/infected aortic aneurysm.</p>Thu, 09 Jul 2015 00:00:00 -0600{216BEF51-2305-4118-B1C9-D5A6EC2C85A2}https://10.40.239.129/blogs/2015/07/answering-questions-about-weight-loss/Answering Questions about Weight Loss<p>Obesity is a growing epidemic in the United States. We hear about this problem on an almost daily basis. Open up an Internet browser and type in &ldquo;obesity epidemic in America,&rdquo; and you get links to numerous articles, graphics, and statistics about this ever-present problem. From my experience as a physician, the worst consequences from this disease are the complications I see in my office every day. These include type 2 diabetes, high blood pressure, heart disease, strokes, obstructive sleep apnea, and many other health conditions(1). I wanted to write this article because I believe weight loss and maintaining a healthy weight are the most beneficial approaches people can use to prevent disease or control the complications of diseases they already have.&nbsp;</p>
<p>Many people understand that losing weight requires exercise and diet. But, the problem that I see with many failed attempts to lose weight is people putting too much importance on exercise while failing to change their diets. They initially lose weight, but can&rsquo;t get to their goals because they haven&rsquo;t changed their eating habits. Exercise is good for many things such as cardiovascular health, endurance, well-being, and staying mentally sharp. But it doesn&rsquo;t burn as many calories as one might think. Diet is the main predictor of weight. One person may be overweight and fit because he or she exercises, whereas another person may be thin and unfit because he or she eats a better diet but doesn&rsquo;t exercise. Most of the calories the average person burns each day are consumed by the normal metabolic processes our bodies go through just to keep us alive.&nbsp;
</p>
<p>Let&rsquo;s challenge the popular adage that states, &ldquo;Losing weight is simply a matter of calories in vs. calories out.&rdquo; Is it really true that if you take in fewer calories than you burn, you will lose weight? For years, I believed it was. I believed it when I graduated from college with a degree in chemistry. All through medical school and for most of my residency I believed that this elementary math would help people lose weight; and I taught it to patients all the time.&nbsp;</p>
<p>Then, in my last year of residency, a faculty member brought up the notion that weight management might not be that simple. Perhaps it also has something to do with the way our bodies process calories.&nbsp;</p>
<p>In processing fats and proteins your body secretes bile and enzymes into your digestive system to break apart these foods and help absorb them. However, once you absorb the fats and proteins, your body decides what to do with these nutrients by also reacting to your carbohydrate consumption. Eating complex carbohydrates and sugars causes your body to release insulin to bring your blood sugar level down. Insulin is a storage hormone. In addition to regulating blood sugar, it also causes your cells to store fat and take up amino acids to produce proteins.&nbsp;</p>
<p>So if you eat three high-carbohydrate meals and two or three high-carbohydrate snacks each day, then your body is in a constant state of trying to store calories instead of burn them.&nbsp;</p>
<p>This principle was shown in an article in the New England Journal of Medicine in May of 2003. It illustrated that severely obese patients, with a body mass index greater than thirty-five percent, lost more weight on a low carb diet than a low-fat, low-calorie diet (2). This changed my perspective. It&rsquo;s not just the number of calories we take in, but also what type of calories we eat that determine our weight.&nbsp;</p>
<p>Weight Loss Recommendations:&nbsp;</p>
<p>1. Diet and exercise are both important in losing weight. Diet is the biggest factor affecting weight.&nbsp;</p>
<p>2. At every meal, make starches &ndash; bread, rice, potatoes, pasta, cereal, etc. - Only one-quarter of your plate. Fill the other three-quarters with lean protein, non-starchy vegetables, and a lesser portion of fruit.&nbsp;</p>
<p>3. Choose small, balanced snacks that mix some carbohydrate (fruit, dairy, grains) with a lean protein or non-starchy vegetable.&nbsp;</p>
<p>4. A diet needs to be a lifestyle change, not something you do for three to six months. If your diet is not a lifestyle change you will become a yo-yo dieter.&nbsp;</p>
<p>5. Your diet will fail if you try to cut out foods you love. Instead, eat everything in moderation, and make the food you love a part of your portioned plate.&nbsp;</p>
<p>6. Don&rsquo;t drink your calories. If you are thirsty, drink water.</p>Thu, 09 Jul 2015 00:00:00 -0600{E07E7E6B-7BA3-4FF4-B578-B0DB653D3423}https://10.40.239.129/blogs/2015/07/assessing-concussion/Assessing Concussion<strong>Baseline Testing Speeds Diagnosis &amp; Recovery</strong>&nbsp;
<p>Concussion has become a hot topic in recent years, not only within the medical and scientific communities, but within the mainstream media as well. Starting a little more than 10 years ago, concussions became viewed not as just a nuisance or &ldquo;part of the game,&rdquo; but as a traumatic brain injury not to be taken lightly.&nbsp;
</p>
<p>With more awareness, more injuries are also coming to the attention of healthcare providers. Approximately 4 million sports-related concussions occur each year in the United States and account for almost 15 percent of all injuries sustained by high school athletes, according to recent studies.&nbsp;
</p>
<p><strong>What is a Concussion?</strong>&nbsp;</p>
<p>A concussion is a functional brain injury, which means there is no real acute structural damage to the brain. It typically stems from an impact injury to the head, although it can occur with an impact to the body while the head undergoes an acceleration and deceleration process known as whiplash. This impact or whiplash injury disrupts the normal functioning of the nerves in the brain so that certain parts of the brain become a little hyperactive and others do not function well at all.&nbsp;
</p>
<p><strong>Why Worry About Concussion?</strong>&nbsp;</p>
<p>Doctors are still learning about the long-term effects of concussions, which can range from nothing to rare learning and memory deficits, depression, personality changes and dementia. Each time someone sustains a concussion it increases the risk of having another one in the future.
Also, if an athlete continues to play before a concussion has fully resolved, there is a high risk of sustaining a more significant concussion and prolonging recovery time&mdash;sometimes by weeks to months&mdash; and therefore a higher risk of having long-term cognitive deficits. In addition, there have even been controversial reports of a Second Impact Syndrome, where deaths have been attributed to severe brain swelling stemming from a second head impact while still concussed.&nbsp;
</p>
<p><strong>How is a Concussion Diagnosed?</strong>&nbsp;</p>
<p>Because there is no visible injury to the brain, this makes it difficult to diagnose through objective measures such as imaging tests like CT scan or traditional MRI. If these tests are performed, it is usually to evaluate for a more significant injury such as bleeding within the skull or brain. Currently, there are no accepted blood tests to diagnose concussion, either. As a result, physicians mostly rely on the patient reporting an impact of some sort, either to the head or the body, along with some of the symptoms of concussion mentioned above.&nbsp;</p>
<p>However, there are some objective tools that can help not only diagnose but also more effectively manage concussion. Proper diagnosis and management of concussion in young athletes helps keep them safe and protect their brains while speeding their recovery to safely return to school and the playing field.&nbsp;</p>
<p>These tools include balance testing, questionnaires about symptoms and computerized neurocognitive tests. These procedures measure short term memory, processing speed and reaction time, all of which can be disrupted in a concussion. The computerized test that is most commonly used nationwide is the ImPACT test, and it is available at McKay-Dee Sports Medicine as well as all the sports medicine physician offices within Intermountain Healthcare.&nbsp;</p>
<p><strong>Concussion Symptoms:</strong>&nbsp;</p>
<p>&gt; Headache&nbsp;
</p>
<p>&gt; Nausea, sometimes vomiting&nbsp;</p>
<p>&gt; Blurred vision&nbsp;</p>
<p>&gt; Dizziness&nbsp;</p>
<p>&gt; Feeling dazed, fuzzy or slowed down&nbsp;</p>
<p>&gt; Difficulty concentrating on things, like schoolwork, reading, etc.&nbsp;</p>
<p>&gt; Loss of memory before and/or after the injury&nbsp;</p>
<p>&gt; Slow reaction time&nbsp;</p>
<p>&gt; Difficulty remembering new things&nbsp;</p>
<p>&gt; Sleepiness&nbsp;</p>
<p>&gt; Anxiety, nervousness&nbsp;</p>
<p>&gt; Intolerance to bright lights&nbsp;</p>
<p>&gt; Intolerance to loud noises&nbsp;
</p>
<p><strong>Baseline Testing</strong>&nbsp;</p>
<p>The ImPACT and other tests mentioned above work best if athletes have baseline scores, meaning they take the test before sustaining a concussion. Typically this is done before the season starts, and is updated about every two years. Those scores are saved in the system, and if a concussion occurs, doctors can compare the athlete&rsquo;s new scores to the baseline.&nbsp;
</p>
<p>If the ImPACT test confirms the diagnosis, doctors can use that information to guide the treatment process. They can also use the individual scores within the test to guide recommendations for school, such as allowing more time for tests, reducing homework load, or no school altogether.&nbsp;
</p>
<p><strong>How is it Treated?</strong>&nbsp;</p>
<p>Most concussions resolve within seven to ten days, with only a few (about 10 to 15 percent) lasting more than three weeks. It is impossible to predict how long the concussion will last for each patient. Recovery estimations can be made based on the particular symptoms immediately after the concussion such as the number of symptoms present, age, gender, and if the patient has had a concussion in the past or certain other medical or psychological conditions.&nbsp;
</p>
<p>Recovery time often depends upon proper management and supervision. A concussion will last longer if it continues to be aggravated, either through physical activity, schoolwork, visits to the mall, playing video games, working on the computer, or even just reading or watching TV. Sleep is vital for optimal recovery, and lack of proper sleep can prolong symptoms and delay healing. There is no pill or procedure that can resolve this injury, although certain medications may be used to treat some of the symptoms of concussion. Sometimes it is helpful for the concussion patient to attend physical therapy.&nbsp;
</p>
<p>During the course of the concussion a patient will continue to be assessed through follow-up visits and phone calls. Once the symptoms have resolved, another ImPACT test is recommended. This is important because it is known that a concussion can still be present even after the symptoms have completely gone away. Once the test scores are back to baseline, then patients can begin the process of returning to sport. This is done in a gradual, progressive manner, sometimes supervised by an athletic trainer at the school, or can be done by a parent after receiving education in our clinics on the process with occasional phone calls from staff to answer questions and check progress.&nbsp;
</p>
<p>Utah state law requires all kids involved in recreational or school-affiliated sports teams receive official medical clearance by a concussion certified healthcare provider before returning to play. Treating concussions must be within the scope of regular practice for such providers, who also must have attended a certified continuing education class on concussion within the past three years.&nbsp;
</p>
<p>If your child has sustained a concussion, or if you would like to inquire about baseline testing, please contact the offices closest to you.
</p>Thu, 09 Jul 2015 00:00:00 -0600